Fibrosis in chronic hepatitis C correlates significantly with body mass index and steatosis

Steatosis is a frequent histological finding in chronic hepatitis C infecti on; however, the pathophysiology of steatosis and its role in disease progr ession have not been established. We studied 148 consecutive patients with untreated chronic hepatitis C to assess the effect of body mass index, diab etes mellitus, alcohol consumption, hepatic iron content, and viral load on steatosis and hepatic fibrosis. Ninety-one patients (61%) had steatosis: g rade 1 (<30% hepatocytes involved) in 61 (41%), grade 2 (30%-70% hepatocyte s involved) in 17 (11%), and grade 3 (> 70% hepatocytes involved) in 13 (9% ). After adjusting for potential confounding variables, a highly significan t relationship was found primarily between steatosis and body mass index (P < .0001), The mean (+/-SD) body mass index of patients with no steatosis w as 23.9 +/- 4.3 kg/m(2), whereas for grade 1 steatosis it was 26.5 +/- 5.1 kg/m(2), and for grade 2 and 3 steatosis combined the body mass index was 2 8.4 +/- 4.9 kg/m(2), Hepatic fibrosis was significantly associated with age (P = .002). After adjusting for potential confounding variables, including age, hepatic fibrosis was also significantly associated with steatosis (P < .03). There was no significant association between hepatic iron content, alcohol intake, gender, and viral load and steatosis or fibrosis. These fin dings suggest that increasing body mass index has a role in the pathogenesi s of steatosis in chronic hepatitis C and that steatosis may contribute to fibrosis, The association between body mass index and steatosis and fibrosi s has important prognostic and therapeutic implications in the management o f patients with chronic hepatitis C virus.